St Clare Commons - Perrysburg Nursing Home
General Information
UPDATEFederal Provider Number
366410
Provider Name
ST CLARE COMMONS
Provider Address
12469 FIVE POINT ROAD
PERRYSBURG, OH 43551
PERRYSBURG, OH 43551
Provider Phone Number
(419) 931-0050
Provider SSA County
880
Provider County Name
Wood
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. CLARE COMMONS
Date First Approved to Provide Medicare and Medicaid services
2013-11-04
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.69419
Reported LPN Staffing Hours per Resident per Day
0.41628
Reported RN Staffing Hours per Resident per Day
1.01047
Reported Licensed Staffing Hours per Resident per Day
1.42674
Reported Total Nurse Staffing Hours per Resident per Day
4.12094
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24884
Expected CNA Staffing Hours per Resident per Day
2.44388
Expected LPN Staffing Hours per Resident per Day
0.72383
Expected RN Staffing Hours per Resident per Day
1.44270
Expected Total Nurse Staffing Hours per Resident per Day
4.61041
Adjusted CNA Staffing Hours per Resident per Day
2.70501
Adjusted LPN Staffing Hours per Resident per Day
0.47734
Adjusted RN Staffing Hours per Resident per Day
0.52334
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60295
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-11-04
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
24.80000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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